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Background: Elevated lipoprotein(a) (Lp[a]) is a risk factor for first atherosclerotic thrombosis events, but the role of elevated Lp(a) in secondary prevention is controversial. This study aimed to retrospectively investigate the influence of elevated Lp(a) levels on the prognosis of patients with coronary artery disease.

Methods: The team collected and compared clinical information of patients hospitalized during percutaneous coronary intervention (PCI).

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Article Synopsis
  • Elevated lipoprotein(a) [Lp(a)] is linked to increased risk of ischaemic heart disease (IHD), and the study aimed to analyze IHD patients with Lp(a) measurements, focusing on the connection between elevated Lp(a) levels and premature IHD.
  • A retrospective study of 521 IHD patients in Singapore revealed that 10% experienced premature IHD, with most having normal Lp(a) levels, though Indian ethnicity and female patients showed higher concentrations.
  • Findings suggested that Lp(a) levels ≥155 mmol/L significantly correlate with the development of premature IHD, highlighting the influence of ethnicity and gender on Lp(a) distribution.
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Clinical and Genomic Prediction of Coronary Artery Disease Subtypes.

Arterioscler Thromb Vasc Biol

January 2025

Department of Genetics and Genomic Sciences (L.L., J.G.-G., H.M.W., C.J.H., P.F.O.), Icahn School of Medicine, New York, NY.

Background: Coronary artery disease (CAD) is a complex, heterogeneous disease with distinct etiological mechanisms. These different etiologies may give rise to multiple subtypes of CAD that could benefit from alternative preventions and treatments. However, so far, there have been no systematic efforts to predict CAD subtypes using clinical and genetic factors.

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  • HIV-associated cardiovascular disease (CVD) is becoming more common, but the reasons for this increased risk in people living with HIV (PWH) are not well understood, particularly regarding lipoprotein(a) [Lp(a)].
  • A study involving 65 PWH and 52 controls found that Lp(a) levels were significantly higher in PWH, and they showed lower coronary endothelial function (CEF) as measured by cardiac imaging.
  • The study concluded that elevated Lp(a) in PWH is linked to impaired CEF, suggesting that Lp(a) might contribute to the increased cardiovascular risk in this population.
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Association of Lipoprotein(a) With Changes in Coronary Atherosclerosis in Patients Treated With Alirocumab.

Circ Cardiovasc Imaging

November 2024

Department of Cardiology, Bern University Hospital, Inselspital (K.C.K., J.H., Y.U., T.O., H.S., R.K., F.P., M.A., J. Lanz, S.W., L.R.), University of Bern, Switzerland.

Background: Elevated Lp(a) (lipoprotein[a]) is a risk marker for atherosclerotic disease, but the underlying mechanisms remain elusive. We examined the association of Lp(a) with changes in coronary atherosclerosis following intensive lipid-lowering therapy.

Methods: In the PACMAN-AMI trial (Effects of the PCSK9 Antibody Alirocumab on Coronary Atherosclerosis in Patients With Acute Myocardial Infarction), 300 patients with acute myocardial infarction were randomized to receive biweekly alirocumab 150 mg or placebo in addition to high-intensity statins.

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